BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ANCHOR FAST ORAL ENDOTRACHEAL TUBE FASTENER # 9799

    MDR report key: 2994285 · Received March 1, 2013

    Report

    Report Number
    MW5029239
    Event Type
    Injury
    Date Received
    March 1, 2013
    Date of Event
    February 28, 2013
    Report Date
    March 1, 2013
    Manufacturer
    HOLLISTER, INC.
    Product Code
    CBH
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NY, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    (B)(6) WITH COMPLICATED MEDICAL/SURGICAL COURSE, S/P HEMICOLECTOMY FOR VOLVULUS WAS EXTUBATED ON (B)(6) - INTUBATED (B)(6). ABOUT 15 MINUTES AFTER EXTUBATION, HE DEVELOPED STRIDOR AND REQUIRED REINTUBATION. ANESTHESIA USED A GLIDESCOPE AS A DIFFICULT INTUBATION WAS ANTICIPATED. THE FOAM BUMPER FROM THE ETT FASTENER WAS NOTED IN THE PATIENT'S UPPER AIRWAY AND WAS REMOVED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    89456 ANCHOR FAST ORAL ENDOTRACHEAL TUBE FASTENER # 9799 ORAL ETT FASTENER CBH HOLLISTER, INC.

    Patients

    Seq Age Sex Outcome Treatment
    1 72 YR Required Intervention